The difference between clinical and bitewing detection of approximal and occlusal caries in Royal Air Force recruits

This paper reports on differences between the clinical and radiographic detection of caries, on both occlusal and approximal surfaces, in a cohort of Royal Air Force (RAF) recruits (mean age 18.9 years). It was found that the clinical examination detected only 30 per cent of the total lesions found by both methods combined. The radiographic examination found 201 per cent extra occlusal dentinal lesions and 192 per cent extra approximal dentinal lesions. In those recruits where caries was evident, the mean number of dentinal lesions found after the clinical examination was 1.0 compared to 2.7 lesions after the radiographic data were added. It was concluded from these results that radiographs are essential for assessment of the prevalence of both approximal and occlusal caries in service recruits. The epidemiological effect, in this age group, of the lower sensitivity of the clinical examination was to underestimate the overall DMFT by 7.8 per cent, although nearly three times as many dentinal lesions were diagnosed from radiographs as were detected clinically.